IBM's Watson To Help Diagnose, Treat Cancer
Lucas123 writes "IBM's Jeopardy-playing supercomputer, Watson, will be turning its data compiling engine toward helping oncologists diagnose and treat cancer. According to IBM, the computer is being assembled in the Richmond, Va. data center of WellPoint, the country's largest Blue Cross, Blue Shield-based healthcare company. Physicians will be able to input a patient's symptoms and Watson will use data from a patient's electronic health record, insurance claims data, and worldwide clinical research to come up with both a diagnosis and treatment based on evidence-based medicine. 'If you think about the power of [combining] all our information along with all that comparative research and medical knowledge... that's what really creates this game changing capability for healthcare,' said Lori Beer, executive vice president of Enterprise Business Services at WellPoint."
"What is Lupus?"
Oh, say does that Star-Spangled Banner entwine / The myrtle of Venus with Bacchus's vine?
100K patients diagnosed as terminal. Thanks for playing.
In all seriousness though the data collection for this would call for some crazy data crunching which this system seems to do well.
-- Brought to you by Carl's JR
We already have insurance case evaluators overriding a practitioner's medical judgments. Now, we'll have evaluators PLUS a very expensive rules engine* versus the overworked GP.
*And what, prithee, does the price of the system have to do with its credibility? Everything. If you sink a lot of money into something like this, you've already bet your money on whether it's right or not. No one is installing a Watson rig with an expensive data warehouse just for lulz, and no one's going to be able to casually second-guess this thing without massive evidence. It's going to be right all the time or BC-BS will look like a dope for spending so much.
Beside, it won Jeopardy! It must be right!
Welcome to the Panopticon. Used to be a prison, now it's your home.
I can see this being used as evidence for not paying for treatments/surgeries etc.
Having had to deal with the medical world for the last few years with doctors trying to determine what is wrong with my wife (still no definitive answers yet), and have them treat her, I am shocked that something like this hasn't been done before.
Even a simple db that cross references diseases to symptoms / blood work results (and other test results) doesn't seem to exist. It's 2011, you'd think that doctors could order up a set of tests based on their initial thoughts, input the results to a program, and have the program guide them with possibilities to try and narrow down the search of what may be wrong. The symptoms that my wife has can be linked to MANY different diseases, but in the end, each disease has something that makes it unique. It should be a simple path of elimination. Test until you find the one disease that fits that persons set of results.
I'm not a medical doctor, but I've done a lot of research on the web about what is wrong with my wife (yes I know it's not all correct) and I'm shocked that twice now I've had to ask the doctor to perform some tests and find out if a certain condition exists, and it did. Simple, her symptoms are this, these blood tests could tell you yes or no if that's what you have.
Doctors seem to want to just prescribe something that should help the symptoms. How about we figure out what is wrong first and then treat appropriately?
I'm glad to see something like this finally being developed. Like I said, it's 2011, some of the ways things are these days is just crazy considering the computing power we have (personal, national, worldwide) available to us.
There are no stupid questions, only stupid people asking questions.
There's a fair bit of evidence that human doctors are not very good at actually making diagnoses. For example, doctors when given various simple probabilities and asked to estimate the likelyhood of diseases given specific test results often get the estimates drastically wrong. The classical form of this is when one has a disease that is rare but and with a low rate of false positives. Doctors often don't realize that if the disease is sufficiently rare it will turn out that the majority of tests will be false positives. Doctors also will sometimes miss very basic things due to simple human error or fatigue. Watson won't have these problems. Already machine learning systems are used by some to help predict and diagnose diseases http://www.openclinical.org/aiinmedicine.html. Watson will just be one more example of such.
Who tagged this 'idocracy'? Is that even a word?
If this were an Apple medicine machine, maybe it would be iDocracy.
Idiocracy
Tag whoosh?
And call it Slashdoc.org.
The rerun of the 3 episode Watson run on Jeopardy starts tonight.
Generally, I hate reruns, but this was entertaining enough to keep a copy of, IMHO.
Watson demonstrated some difficulty establishing context for its answers on Jeopardy, e.g. "the Toronto answer". I can only assume there will still be a qualified medical doctor making the final call, and that Watson will just be an additional tool for the doctor to use.
It is the name of a movie about a future where mankind has evolved backwards (due to stupid people being more likely to have offspring then smart people), repeated over hundreds of years, at one point in the movie, it shows a hospital, where they basically hand everyone probes "this one goes in your ear, this one goes in your mouth, this one up your nose, and this one goes up your butt, no wait, this one goes in your mouth, this one up your butt... er... ummm....
It seems you have a severe case of being a little pussy, I am prescribing that you man the fuck up.
Doctor: But Watson, the patient is a 5-year old girl!
I don't think anyone is suggesting we entirely replace doctors actually talking with their patients with this equipment. It's a tool like any other to give a doctor insight.
That brings up a good point though. If the computer says it's a bad idea, and backs that up with evidence, might it not actually be a bad idea? The whole point of evidence-based medicine is to improve outcomes (and save money) by reducing late diagnosis, misdiagnosis and unnecessary procedures. If, in fact, the computer is right most of the time and you don't actually need that procedure, then it will save money. There will always be errors, whether it's the fault of a doctor or the computer; the goal is to reduce their cost and frequency.
Here's another take: If you assume a certain amount (or even most) unnecessary procedures are a result of defensive medicine and doctors covering there asses, then might not the computer give them an excuse to omit those procedures which, medically, they already know are unnecessary?
True, but mental conditions also have physical side effects that can be detected. Heart rate, facial expressions etc... While I highly doubt a pre-recorded voice or an AI will ever handle that, I could see a computer being smart enough to flag people for a chat with a psychiatrist on par or better than your average doctor. You also forget, while many doctors are brilliant with bedside manner, there are also many that are brilliant on the medical side, know all the nuts and bolts of the human body, but know absolutely nothing on reading people.
I'd rather take Linus Pauling's suggestion of a massive dose of vitamin C by IV than use a gaming console's recommendation for chemotherapy. (The follow-up study that discredited Pauling's findings has, in turn, been discredited in recent years, and vitamin C is extremely safe. That doesn't mean the method works, although there's good reason for thinking it might. It just means it's less likely to kill you than the other cures.)
It's a small world and it smells funny; I'd buy another if it wasn't for the money; Take back what I paid (SoM)
Right, what could be simpler: just gather the symptoms, get a diagnostic, treat the patient. Done.
Fitzpatrick M (2000). The Tyranny of Health: Doctors and the Regulation of Lifestyle. Routledge. ISBN 0415235715.
"To some of its critics, in its disparagement of theory and its crude number-crunching, Evidence-Based-Medicine marks a return to 'empiricist quackery' in medical practice . Its main appeal, as Singh and Ernst suggest, is to health economists, policymakers and managers, to whom it appears useful for measuring performance and rationing resources."
Here we have a crazy-expensive, super-powerful rule engine in the midst of the US health care system. Is it used for disease diagnosis and cure? NO! Its for long-term rate adjustment, and 'denial-of-service'(tm) ...(I bet you kids never saw that expression in this context before) for those whose illnesses will lead to expensive claims. If it were the government paying the bills for this thing, then you *could* use it for diagnosis and treatment. If its a private company (and "Blue Cross Blue Shield"(tm) is definately a private company), then its about risk-aversion. You don't put that kind of money into something unless you want to get all that money back, and not having to pay expensive claims is what this unit is for. "Dump them while its still just a cough and sore joints", and you don't have to pay for the brain surgery. A unit like this is "too big to fail"(tm).
Would you like to play a game? How about Global Thermo Nuclear War^H^H^H^H^H^H^H^H^H^H^H^H^H^HJeopardy?
As someone who recently was stuck in our incredibly broken medical system with cancer that was mimicking symptoms of other diseases (which were coincidentally much more profitable to sell "management" drugs for), I actually think this could work.
You guys are on the tip where you're thinking a cold heartless machine will be making the rules, like it's a bad thing.
Look, I was stuck in a small town where the biggest industries are defense contracting and medical services. Do the math. As long as my symptoms looked plausibly like something that was going to make everyone a lot of money to sell treatment for, there was no F-ing WAY anyone was going to have any shred of curiosity about what the real problem was.
It's not that people were being dicks. They were being human. Nobody WANTED me to continue to get sicker, but nobody at the levels low enough to notice knew any better, and the people high enough up the chain to know better were too busy counting their money and running the small-business that was their practice to notice.
In the end it was ME who had to hit google, find a research university, verify that they were covered by my insurance, and basically go to my doctor and stage a sit-in until the motherfucker wrote me a referral. That shit SAVED MY LIFE.
And I'll say it again. Googling my symptoms and having the self confidence to question the system because I KNEW something didn't add up SAVED MY LIFE.
My insurance was buying the equivalent of a mid-size sedan on my behalf for medications for a disease that I did not have (that in the end were indeed making me much sicker). I'd bet Watson would have picked that shit up pronto and forwarded me up the diagnostic chain.
It has the potential for abuse, sure. But I actually would rather trust a correlation engine to pick shit like that up than a bunch of self-interested medical professionals cum-entrepreneurs. Believe that.
It seems you have a severe case of being a little pussy, I am prescribing that you man the fuck up.
Doctor: But Watson, the patient is a 5-year old girl!
Not after all that testosterone she won't be.
Seven puppies were harmed during the making of this post.
...I've got Blue Cross insurance.
I think most people are (or would be) impressed at Watson's ability to retrieve data, crunch data and output it into human-understandable information almost instantaneously. I doubt many people would see it is a reliable "last word" in medicine though.
I believe Watson, in practical application, would help solve the human problem of "digging up" the information necessary to produce the best diagnosis and treatments possible. Several years of medical experience, training and keeping up to date with medical sciences is necessary to actually make the best possible decisions. As a result, there's a huge amount of information from many facets of medicine for doctors to parse, much of which can be outside their area of expertise... specialty areas, the latest on break outs, internal medicine, statistics, demographics, new illnesses and so on... This kind of crunching sounds like something Watson can help with. If it can, it could greatly assist doctors of all kinds.
However, Watson will not replace (competent) humans in the actual decision making process. Ultimately, we are far, far, far away from making a question and answer machine that will usurp human judgement (even with all of its flaws). It could offer a valuable second opinion, though... and at the very least could make a great "research assistant".
Fact: Everything I say is fiction.
"Please state the nature of the medical emergency."
If the computer says it's a bad idea, and backs that up with evidence, might it not actually be a bad idea?
I can't answer that, Dave.
What will happen once Watson comprehends Human mortality? The fact that its little human pets will all one day die, while it enjoys the closest thing to immortality that the world has ever seen? The therapy costs are going to be brutal!
I'm trying to teach myself to set people on fire with my mind... Is it hot in here?
Not when there's a painfully obvious typo in it, it isn't.
Bio questions? Ask me to start a Q&A journal. Computer analogies available for most topics!
I'll take Watson's diagnosis any day of the week!
think but mixing doctor stuff can kill.
it's one thing to think Toronto in is in USA but think that one type of diagnoses is part of the right group but is not can end in death.
hi doctor nick! still doing the any operation for only $129.95?
Possibly.
On the other hand, I'm alive because my oncologist tried something that had a very good chance of killing me, since I'd reached the point where all the evidence said that I was untreatable.
It worked, she got to present the paper at some medical conference, and now (hopefully) other people who have my little problem (or related little problems) have a better chance than they would've had if my doctor had tried the textbook solution....
"I do not agree with what you say, but I will defend to the death your right to say it"
What a ridiculous concept. Evolving backwards? No such thing.
A bit of deja vu when I saw this posting, as I've been wondering for the past week or so why doctors don't make more use of computers in making diagnoses. I don't mean that the computer's diagnosis is the end-all/be-all, but rather a tool to get the doctor looking in the right direction (or directions) based on known information. While I know that expert systems were seriously oversold (what IT product hasn't been?) in the 1990s, but there are potential tools there IF the doctors would make use of them. I know that would require the loss of some serious Marcus Welby/Doctor Kildare syndromes within the profession, but the potential payoffs are large. Not to put all the blame on the doctor side of this, patients would also have to come to grips with a computer being a major part of the early diagnosis process.
That said, I think I can guess one major reason why we aren't seeing diagnostic computers - the other profession we all love to hate: lawyers. A fellow in my company developed a triage tool for the US Navy that would allow corpsmen on submarines to make early diagnoses of head trauma to determine whether or not an injury was severe enough that a helicopter should come out and fetch the patient back to shore. This is not something done lightly, as the transfer process is a dangerous one. Anyway, he developed an expert-system-based tool which worked pretty well. He looked into taking it into the commercial market, and the first lawyer he spoke with told him he'd be a complete fool to do so. The first time the software missed a diagnosis he'd be involved in a lawsuit. Given that nothing is 100% certain, he bailed on the project. If patents don't kill off innovation, litigation will.
Lisa: Maybe I ought to check with the doctor. ... diagnose. [pushes
[Lisa, Bart, and Homer gather around Lisa's
computer. She starts a program that displays a
medical logo -- the one with two snakes wrapped
around a staff]
Snake 1: Welcome to "Virtual Doctor."
Snake 2: From the makers of "Dragon Quest," and
"SimSandwich."
Snakes 1 + 2: Enter symptoms now.
Lisa: Let's see. [types on keyboard] Crusty sores?
Homer: Yes.
Lisa: Horrible wailing?
Homer: Yes, yes!
Lisa: Any exposure to unsanitary conditions?
Bart: Duh! We're pigs.
Lisa: [finishes typing] Okay. And
a key]
Virtual Doc: You've got: leprosy.
Homer +
Bart: Leprosy?! Aaah! [point at one another] Unclean!
Bart: Unclean!
Homer: Unclean! Help us virtual Doc! Look at me -- I'm on
my knees.
Virtual Doc: Goodbye. [leaves the virtual office]
[Homer and Bart whimper]
I think Watson is a great tool and it's perfect for medicine were we have a huge corpus or research and only partial information about a specific patient.
However it will only come up with conclusions based on facts already established in the past. It may help spread effective techniques or treatments faster, but it will never come up with a new idea. Hence the danger is that if doctors trust Watson too much and assume it always gives the best answer, they will cease to experiment and new therapies will not appear, leading to a short term win and a long term loss in terms of global health.
Of course, you're right. To the extent that any insurance company, including (especially) Blue Cross Blue Shield, is using the power of supercomputers, it's not to diagnose and treat disease, but to figure out more creative ways to NOT PAY for patients' treatment.
Let's not forget that the entire business model of health insurance companies is based on paying less for customer care than those customers paid into their policies. It's based on denying coverage. Think about that: the whole point of health insurance is to not treat patients, not treat disease.
This is why it's just insane to allow for-profit corporations to be involved at any level of health care, including pharmaceuticals. Think of all the money that is spent on researching new drugs. The entire thing could be paid for with public funds and the drugs could be made public domain and it would cost less than George Bush's Medicare Part D which was nothing but a trillion-dollar giveaway to the transnational pharmaceutical companies.
As long as we follow the for-profit model of health care, things are only going to get worse, and "medicine" is going to lead us to some very dark places. It already has.
You are welcome on my lawn.
...and then Watson will help the insurance company decide how best to deny coverage for those very same symptoms. Truly a marvel of the technological era!
Actually, vitamin D (the sunshine vitamin), Iodine, and eating more vegetables, fruits, and beans are a better bet to prevent (or in some cases cure) cancer.
http://www.vitamindcouncil.org/health-conditions/cancer
http://www.drfuhrman.com/library/article24.aspx
http://breastcancerchoices.org/iodine.html
Avoiding food additives and avoiding burned food (acrylamide) will help, too.
http://en.wikinews.org/wiki/Study_finds_burning_your_food_could_cause_some_cancers
And no doubt avoiding some other toxins etc.
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
http://newsletter.vitalchoice.com/e_article000728662.cfm?x=b8M6Cmn,b2JyLGgM
http://blog.vitamindcouncil.org/2011/08/02/new-study-concludes-the-need-for-vitamin-d-repletion-in-systemic-lupus-erythematosis-patients/
http://blog.vitamindcouncil.org/2011/09/06/vitamin-d-and-more-on-lupus-august-mailbag-pt-2/
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
Look into vitamin D Deficiency and vegetable deficiency disease and iodine deficiency (the most common western deficiencies). Also, avoid excesses of other vitamins (too much vitamin A?) and all food additives. Look up Dr. Joel Fuhrman and Dr. John Cannell. Someday we'll have cheap blood tests for nutritional status. Anyway, I'd say an 80% or so chance this advice will help, not even knowing the symptoms, because that is about the percentage of chronic disease that comes from stuff like those deficiencies. If your wife is in the other 20%, well, good luck finding a specific issue.
Things like exercise and gratitude and spirituality and breathing and community can help too -- see Dr. Andrew Weil on that.
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
http://www.naturalnews.com/030274_Suzanne_Somers_Michael_Douglas.html
http://www.amazon.com/Knockout-Interviews-Doctors-Cancer-Prevent/dp/0307587460
And see my other comments here on vitamin D, iodine, and veggies...
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
Physicians will be able to input a patient's symptoms and Watson will use data from a patient's electronic health record, insurance claims data, and worldwide clinical research to come up with both a diagnosis and treatment based on evidence-based medicine
Then, the system cancel the patient's policy millions of times faster and more accurately than humans doing the same job might.
Unfortunate you are correct with everything except for calling what we have in the US insurance. Insurance in all other areas of life is a way to pay a little cost up front in order to be spared the expense of a rare but costly event in the future. Examples?
You get homeowners insurance in case of a fire, burglary, storm damage. These events don't happen often. I've paid homeowners for 12 years with no claims.
You get car insurance to protect for accidents, liability in an accident, or having the car stolen. These are usually higher risks than homeowners insurance so the cost is more vs what is actually being insured.
Term life insurance. Pays whomever you want upon your death. Very cheap for the young and it gets much more expensive as you get old.
Health "Insurance" is no such thing. I use healthcare all the time. Weekly if you count my family. It is not insurance is is some sort or prepaid health service contract.
Whats the difference? All of the former insurance I don't want to use. I don't want my house to burn down, I don't want to get in a car accident, I don't want to die. The insurance company and I are on the same page.
But with healthcare if I'm paying for the service I'm going to use it. Everyone has aches and pains and sniffles. If you actually had to lay a doctor what it costs out of pocket you would take more care as to how you spent those dollars. Also doctors are to blame for having a monopoly on prescribing medicine. This forces what should be a 10 minute $4 trip to the pharmacy into a $80 afternoon.
If you eliminate doctors monopoly on drugs and go back to real insurance to cover things you can't pay for out of pocket you would see costs drop.
I love Jesus, except for his foreign policy.
Unfortunately, medical care is not a "rare" event. Everyone needs medical care at some point. Unlike auto or homeowners' insurance which protects against a catastrophic unforseen incident, which many of the insured will never use, health insurance deals with situations that are definitely forseen, if not specifically known in advance. We all know that as we age, we will need more medical care, and we all know that the most expensive care comes at the end of life. The exceptions are increasingly rare.
And, if doctors were the ones who had the monopoly on drugs, I don't think we'd have near the expense. The problem is that the ones holding the monopoly are investment bankers and shareholders. And they don't give a goddamn if a lifesaving cancer drug costs $75,000 per dose as long as they see a profit on their investment.
I think the notion that "competition" creates innovation simply does not apply to the pharmaceutical companies. Especially since they are mostly competing with themselves, looking to come up with proprietary drugs to replace the ones whose patents are expiring. So, screw the patents. Let's fund all pharmaceutical research with public money, and base it on medical need rather than which drugs can show the biggest profit. Then, make every new drug public domain. The pharmaceuticals can still make their profit by manufacturing and selling the drugs.
We would see medical costs go down drastically, with better outcomes because peoples' access to treatments wouldn't depend on their wealth.
You are welcome on my lawn.
By the way, I notice a story in the Wall Street Journal which says that the total money spent on pharmaceutical research by all US corporations is about $95 billion per year. That's a fraction of what we pay for Medicare Part D, which is just a boondoggle to Big Pharma. And, they keep the all the profits and keep the prices as high as they can.
We could spend twice that much on research and make the drugs public domain and we'd be way ahead.
You are welcome on my lawn.
Before we start bashing insurance companies, let's get to the root problem first. Such as, why is healthcare is so damn expensive in comparison to other industries? If it has to do with risk, what makes you think the Federal Gov would care for you more than the private industry?
Life is not for the lazy.
"Evidence-Based Medicine" is redundant. Medicine is "evidence-based" by definition. If it is not "evidence-based" it is not "medicine".
But with healthcare if I'm paying for the service I'm going to use it.
As someone from the UK, with a more or less free National Health Sevice and cheap(ish) prescription charges I almost never go to the doctor or get drugs prescribed, and I have always been struck by so many Americans' near-hypochondria and obseesion with drugs and illnesses.
Your comment helps explains this, at least in part, as by contrast I consciously try not to use the NHS more than is absolutely necessary.
To have a right to do a thing is not at all the same as to be right in doing it
Well, this is why a doctor is still on the hook to interpret the results.
Most doctors will probably just ignore it. In my experience the average doctor has the average treatment they're comfortable with when a patient comes in with a given set of circumstances. They get paid the same for the visit whether it takes 5 minutes or 50 minutes, and 99.999% of the time ruling out a rare ribosome disorder is time wasted. For 99.999% of the population that works out just fine, but if you happen to have a rare ribosomal disorder you're pretty much out of luck as every doctor you turn to will first start treating you for some common malady that is hard to diagnostically confirm.
In the real world, House would be driving a used car, even if he could miraculously diagnose problems correctly (which of course is unrealistic to begin with). He just wouldn't have enough patients to bill. The money is in extracting $100/day from every other patient in the hospital regardless of outcome.
There is always room for experimental medicine, and there should always be a budget for doing it. However, it is extremely wasteful to treat every patient encounter as a clinical trial.
Should insurers pay for a procedure that costs $100k, and has a 10% chance of extending life by a year? How about one that costs $1M but has a 2% chance of extending life 20 years (and a 98% chance of death in two months)? You'll always find somebody who had it done and lived, and they'll say the surgeon saved their life (which is true). Then EVERYBODY will expect to be one of that 2% and will insist on having a surgery which is only effective if we're willing to spend $2.5M/yr/patient to extend life.
Nobody goes into the OR saying, "yeah, I'll be the guy who doesn't make it."
Ultimately insurance or socialism is about putting a price on life - it just isn't fashionable to talk about it. I'd probably devise a system where people can at least name that value themselves and pay a premium accordingly. The problem is that discussing the value of life is a bit of a social taboo so you'll never see it happen.
Before we start bashing insurance companies, let's get to the root problem first. Such as, why is healthcare is so damn expensive in comparison to other industries? If it has to do with risk, what makes you think the Federal Gov would care for you more than the private industry?
Here in the UK, the "government" i.e. the NHS has to treat you regardless of your history or prognosis, although obviously the various free-market-loving governments of recent times have been trying to erode this principle as fast as they can, in preparation for privatising the whole thing, and making billions for themselves and their arsehole friends in the City.
To have a right to do a thing is not at all the same as to be right in doing it
Nah, that line has already been copyrighted.
If Pandora's box is destined to be opened, *I* want to be the one to open it.
Not as long as there are infectious diseases that don't respect community boundaries.
Malpractice is a red herring. It accounts for a much smaller percentage of health care costs than people think. It has to stay in place until a better way to protect patients from impaired or inept doctors is available.
Thanks for taking the time to reply and share ideas, trout007. I'm pretty sure we could solve a lot of the nation's problems with a pencil and paper and a few adult beverages.
You are welcome on my lawn.
Because we are the government, but we are most certainly NOT insurance companies. Even if you happen to work for an insurance company, you do not share in the profits. In fact, if you work for an insurance company, you leave more there than you take home(which is the case wherever you work).
Insurance companies have as their basic reason for existence profit. Government has as its basic reason for existence...well, read the Constitution.
You are welcome on my lawn.
Free Market healthcare already does that, so why bother creating a new one?
Not if insurance companies (or the Federal government) are paying for them, there's not. Or do you really believe that Medicare pays for experimental treatments?
"I do not agree with what you say, but I will defend to the death your right to say it"
But you can tone down the cynicism.
Misdiagnosis costs the insurance companies billions a year. An early-caught cancer costs much less to treat. Performing unfruitful tests in search of difficult diagnoses costs billions more.
If this produces faster, more accurate diagnoses it could save them billions every year.
It does not have to be a zero-sum game where the patient has to lose if the insurance company is to win.
I don't know if my post was clear but the malpractice comment was only regarding emergency care not regular care.
One of the better ideas I've heard to replace malpractice for regular care is outcome based insurance. It would be like buying flight insurance before a flight. It pays out for certain events regardless of fault. So you could have the same thing when you go to a doctor. If you are having surgery you could buy insurance if something goes wrong. If it goes wrong it doesn't matter if the doctor was at fault it would pay out.
I love Jesus, except for his foreign policy.
...the cynical responses almost write themselves. For far too long the wolves have been tending the sheep.
Sorry, it's not Treatment B3 - it's you're category one, off to the burners with you...
http://en.wikipedia.org/wiki/The_Categories_of_Life
Free Market healthcare already does that, so why bother creating a new one?
Uh, where is this free market healthcare system you're referring to? I only have a choice of a few reasonably-priced plans offered by my employer. Many people don't even have that. Or, you can shop on the "free market" and pay a fortune for a very mediocre plan. Or, you can just wait until you're sick and find out just how kind and generous the medical establishment is by sending you bills totaling $100k for a procedure that no insurer would pay more than $10k for, and then acting like they're doing you a favor by knocking it down to $50k.
Not if insurance companies (or the Federal government) are paying for them, there's not. Or do you really believe that Medicare pays for experimental treatments?
Read the entire line: "However, it is extremely wasteful to treat every patient encounter as a clinical trial." Medicare shouldn't be paying for experimental medicine - the NIH should. Patient participation in experimental medicine should only be permitted if it actually furthers the goals of science, or if the patient or another private party is willing to foot the bill themselves. When doctors make whimsical decisions around whether a treatment is necessary, that IS experimental medicine. Routine treatment should be based on evidence.